Abstract
The Kidney Donor Profile Index (KDPI) was introduced in the United States in 2014 to guide the decision making of clinicians with respect to accepting or declining a donated kidney. To evaluate whether the KDPI can be applied to a European cohort, we retrospectively assessed 580 adult patients who underwent renal transplantation (brain-dead donors) between January 2007 and December 2014 at our center and compared their KDPIs with their short- and long-term outcomes. This led to the observation of two associations: one between the KDPI and the estimated glomerular filtration rate at one year (1-y-eGFR) and the other between the KDPI and the death-censored allograft survival rate (both p < 0.001). Following this, the individual input factors of the KDPI were analyzed to assess their potential to evaluate the quality of a donor organ. We found that a donor’s age alone is significantly predictive in terms of 1-y-eGFR and death-censored allograft survival (both p < 0.001). Therefore, a donor’s age may serve as a simple reference for future graft function. Furthermore, we found that an organ with a low KDPI or from a young donor has an improved graft survival rate whereas kidneys with a high KDPI or from an older donor yield an inferior performance, but they are still acceptable. Therefore, we would not encourage defining a distinct KDPI cut-off in the decision-making process of accepting or declining a kidney graft.
Highlights
The Kidney Donor Profile Index (KDPI) was introduced in the United States in 2014 to guide the decision making of clinicians with respect to accepting or declining a donated kidney
We included the following recipient- and procedure-specific variables which, according to the aforementioned preconsiderations and preliminary univariate analyses, can potentially impact on the graft’s function: age, sex, body mass index (BMI), dialysis vintage (DV), cold ischemia time (CIT) of the donor organ, condition of previous RTx, human leucocyte antigen (HLA) -matching and current panel reactive antibodies.The results were presented as regression coefficients (B) with 95%-confidence intervals
The mean dialysis vintage was 72 months, and interestingly, lower KDPIs were associated with longer waiting times (85% KDPI)
Summary
The Kidney Donor Profile Index (KDPI) was introduced in the United States in 2014 to guide the decision making of clinicians with respect to accepting or declining a donated kidney. To evaluate whether the KDPI can be applied to a European cohort, we retrospectively assessed 580 adult patients who underwent renal transplantation (brain-dead donors) between January 2007 and December 2014 at our center and compared their KDPIs with their short- and long-term outcomes. This led to the observation of two associations: one between the KDPI and the estimated glomerular filtration rate at one year (1-y-eGFR) and the other between the KDPI and the death-censored allograft survival rate (both p < 0.001). The ECD/SCD labeling has been proven to insufficiently predict the prognosis, as kidneys are suspected to be discarded unnecessarily due to the stigmatization that arises from the ECD/SCD label[19,20,21]
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have